Doctors: Heroin is the new drug of choice on Nantucket

Pill sale enforcement, cheap street drugs seen as reason for change

NANTUCKET — Along one of the dozens of dirt roads that traverse Nantucket's middle moors, an island fisherman spotted a discarded hypodermic needle and burned aluminum can through the brush last week, and knew immediately what it meant. Heroin.

Comment

By JASON GRAZIADEI

capecodtimes.com

By JASON GRAZIADEI

Posted Feb. 10, 2013 at 2:00 AM

By JASON GRAZIADEI

Posted Feb. 10, 2013 at 2:00 AM

» Social News

NANTUCKET — Along one of the dozens of dirt roads that traverse Nantucket's middle moors, an island fisherman spotted a discarded hypodermic needle and burned aluminum can through the brush last week, and knew immediately what it meant. Heroin.

The dangerous narcotic has returned to Nantucket in a new wave of increased use dating back to last summer. There have been arrests for heroin distribution, several nonfatal overdoses, a spike in the number of people seeking help for their addiction, and even a 16-year-old boy arrested for carrying heroin to the island. The incidents have put island law enforcement on alert and tested the limits of Nantucket's drug treatment agencies.

When Dr. Tim Lepore describes Nantucket's current heroin problem, he sums it up in two words.

"It's crazy," he said repeatedly last week.

Lepore, who administers a Suboxone clinic for recovering island heroin and opiate addicts out of his office on the Nantucket Cottage Hospital campus, has watched with increasing alarm as the number of cases he handles continued to grow in the past year. Suboxone is used to help people end their addition to opiates such as heroin.

"I've seen a tremendous uptick in the number of cases of heroin use, and disappointingly enough, among young people — the under-25 crowd," Lepore said. "I think part of it is because heroin is extremely cheap right now, and pills are expensive. I think it's a tragedy. A real tragedy."

At Family and Children's Services, the agency on the front lines of the island's struggle with opiate addiction, the influx of heroin cases in recent weeks has been dramatic, according to executive director Peter Swenson.

"They can get it (heroin) anytime they want," Swenson said of the prevalence of the drug on Nantucket. Swenson works with Lepore's office to administer its outpatient drug treatment clinic and said the 30 spots in the program are currently filled.

"And it's always full," Swenson said. "Any drug use is of concern, but particularly when you see an increase in heroin. That's a concern because of how addictive it is, and the risk of overdose. Even more concerning is a really dramatic increase in IV heroin use. We had seen it over the last three years occasionally, but in the last month and a half, we've had six people come in who are IV drug users. It's been an incredibly dramatic increase."

If that many people are actively seeking assistance for their addiction, Swenson said, it's indicative of a large number of people shooting heroin on Nantucket who are actively using but unable or unwilling to get help.

In July, in a quiet mid-island neighborhood, a Nantucket police SWAT team raided the home of a suspected drug dealer and discovered heroin, cocaine and marijuana just 150 yards away from the Wee Whalers preschool.

The same month, an island resident was arrested for heroin possession during a traffic stop.

In December, a suspected drug dealer attempted to swallow several bags of heroin in his possession as he ran from Nantucket detectives.

And just last month, a 16-year-old boy from Cotuit was arrested with heroin at Barnstable Municipal Airport, where police accused him of flying from Nantucket to Hyannis to pick up the narcotics for distribution on the island.

The boy told investigators that "he was paid to pick up the heroin for someone on Nantucket," according to a statement from Barnstable police.

"Heroin has been making a comeback for a number of years now, for a lot of different reasons," Nantucket Police Chief Bill Pittman said. "A lot of people thought a few years ago meth was going to become the big drug and take off here. But it seems to have retreated a bit, and heroin seems to have resurged."

Pittman, Swenson and Lepore all pointed to two major factors they believe have contributed to the rise in heroin use on Nantucket.

One is the relatively low cost and widespread availability of heroin on the island. It now costs less, and is easier to find, than prescription opiates such as OxyContin and Percocet.

The other factor is the Nantucket Police Department's recent drug busts that have eliminated a number of the key distributors of prescription pills on the island, leaving the door wide open for heroin to reappear.

Pittman noted that the crackdown on prescription opiates has been happening on a larger scale and was not limited to just the recent busts on Nantucket.

"There's been a lot of efforts nationally to address the pill mills, the oxys, so it's a combination of what we've done locally, but also what's been happening on a national level to shut down the transportation of these types of drugs," Pittman said. "What typically drives the latest drug of choice is the availability of the supply. And whatever efforts took place to address OxyContin, if the supply dried up from that, they find something else, and heroin is the drug of choice at the moment. As that is investigated and people start figuring out how to cut that supply off, it will lead to something else."

Many of Nantucket's heroin users never make it to the criminal justice system and instead end up in the emergency room at Nantucket Cottage Hospital.

While there were no hard numbers available from the hospital, according to communications officer Bill Ferrall, Lepore mentioned two recent nonfatal overdoses related to heroin use.

The police department similarly does not have precise statistics on the number of heroin overdoses on Nantucket, as many incidents are reported simply as medical calls, Pittman said, and may not even involve the police.

But "there's been a lot of close calls," he said. "I have no idea what the total number is. I know there's been quite a few."

While the Family and Children's Services outpatient clinic provides treatment for 30 people on Nantucket, the need for those services far outpaces the available resources. Swenson is often forced to make referrals to the Gosnold addiction treatment and recovery centers on Cape Cod.

For the Nantucket Police Department, the way to address the current influx of heroin is to continue its narcotics investigations, Pittman said, and focus resources on identifying and apprehending the suppliers, rather than users.

"We're involved with the state and DEA task forces, so as a local department, we have a little more influence to directly work with state and federal authorities and that helps us," Pittman said.

"It helps us to identify the sources of the drugs and direct our resources to that, rather than so much directed at the locals, just picking them off one at a time. We would rather see the sources be addressed and the local folks get help, whether it counseling, medical or rehab."